? 12/28 Pickle AMPS 176->311 @+1 dosing question (complex health; pancreatic enzymes)

rachel & pickle

rachel & pickle

Member Since 2025
Hello, this is my first time posting wasn't expecting to have to in this way so soon. Pickle has suspected EPI and is on a pancreatic enzyme trial, which has been driving his BG values wayyy up so he's taking higher insulin now. Pre-enzymes he was getting 1U 2x daily unless his preshot was above 270 then he would get 1.5U. When we started enzymes it just kept going up and up and I decreased the enzymes to like 1/4 dose and increased the insulin to 2.5U. Then I increased the enzymes and had to increease the insulin again. Trying to work him up to taking enough enzymes to help him absorb nutrients. So, for his current dose of enzymes, he's at 3.5U 2x daily we're only on day 4 of that amount. This morning's preshot was pretty low, 149, took again 30 minutes later and it was 142. I do know when I feed him it usually goes WAY up pretty quickly and he's hungry right now. Should I give 3u instead of 3.5?
 
Phew, OK--we went up to 9.6 (173) so I shot as usual. This still feels really low to be shooting as usual though so I'll be watching closely. He did, fortunately, have an absolutely massive meal (1/2 can of ZD which is, unfortunately, medium carb and also hypoallergenic and what he can digest right now). I am still wondering if this lower preshot means I can keep insulin as is and do an increase in enzymes and/or lower the insulin a stitch.
 
Hi! I'm way out of my depth here, so I'm not really able to offer advice on dosage, but I do want to point out the prefix function - if you add a "?" prefix to your first post in the thread (the dropdown appears to the left of the "thread title" field), that will help get eyes on your posts faster when you have a question. Especially right now, when holidays have people visiting/replying more sparsely. You could add text to your thread title, too, like "dosing help needed" or similar. Some of our veteran users tend to scan through rather quickly to find the posts where they can help the most.

It sounds like you and Pickle have been going through some stressful stuff! It's hard managing multiple complex health issues in kitties. I hope you can get some good advice quickly. ❤️
 
Allie & Gen said:
Hi! I'm way out of my depth here, so I'm not really able to offer advice on dosage, but I do want to point out the prefix function - if you add a "?" prefix to your first post in the thread (the dropdown appears to the left of the "thread title" field), that will help get eyes on your posts faster when you have a question. Especially right now, when holidays have people visiting/replying more sparsely. You could add text to your thread title, too, like "dosing help needed" or similar. Some of our veteran users tend to scan through rather quickly to find the posts where they can help the most.

It sounds like you and Pickle have been going through some stressful stuff! It's hard managing multiple complex health issues in kitties. I hope you can get some good advice quickly. ❤️
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Ohhh... Thanks so much for this!
 
Ok, so he did have an extra big meal with his shot (normally eats about 1/4 can-3/8th can, but had 1/2 can) and I matched the enzymes to, that so it was a higher dose of enzymes at once...but at +1 I'm seeing 311, which is a huge spike. He definitely has been spiking high on the enzymes, but it seems extra high today (like, yesterday it went 211 Preshot to 302 @ +1.5; vs today going from 176 preshot to 311 @ +1). Probably because of the massive meal + high enzyme dose

[I'm slightly concerned he got a fur shot and I didn't notice at the time...His body condition is really really low rn (a 1-2 on the scale) and needles go right through him so I was getting a lot of these with the 1/2" needles. I switched to the 6mm human needle a couple weeks ago and haven't gotten a fur shot since then...I can smell some insulin on him, so it is possible that I screwed up, but it's also possible that a bit of insulin got on the syringe at the base of the needle (that has happened before). I'll have to wait and see...].

The fact that he would only get 1U if he wasn't having enzymes makes this higher dose to match the enzymes feel really scary to manage because I have to be physically around to give him enzymes with each meal, and I have to assume that if he's not eating and getting enzymes he could go hypo like that. At the moment, it's possible for me to work from home and only leave him for very short periods of time. Very soon though I'm going to need to be on site for half days 2x+ per week (I'll be gone for about 4-4.5 hrs including travel). It would be helpful to eventually be able to leave for a full 8-hour day at least once in a while... I'm hoping that as he gets used to the enzymes his insulin needs to match them reduce a bit, but I have no real reason to assume that's true.
 
Hi Rachel! Welcome to the forum!! Don't be surprised if your post is moved to the main forum. The moderators like for new folks to post there first so that your post is more likely to be seen (the Lantus forum is BUSY and posts can slip to the bottom of the list quickly).

What is the Hills ZD combo? Is that a wet or dry food or both?? I'm thinking wet, since you say canned, but just making sure there is no kibble also. I'm asking because your spreadsheet says you are following TR, but Pickle needs to be on a wet food diet only (no dry/kibble) to follow TR.

I don't know anything about the enzymes + insulin, so hopefully this comment will bump you up and get some attention to your issues from more experienced folks.
 
Mary & Jude said:
Hi Rachel! Welcome to the forum!! Don't be surprised if your post is moved to the main forum. The moderators like for new folks to post there first so that your post is more likely to be seen (the Lantus forum is BUSY and posts can slip to the bottom of the list quickly).

What is the Hills ZD combo? Is that a wet or dry food or both?? I'm thinking wet, since you say canned, but just making sure there is no kibble also. I'm asking because your spreadsheet says you are following TR, but Pickle needs to be on a wet food diet only (no dry/kibble) to follow TR.

I don't know anything about the enzymes + insulin, so hopefully this comment will bump you up and get some attention to your issues from more experienced folks.
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Ah, I see (re needing to be on only wet for TR)—ok, in that case I guess I’ll have to do the SLGS one then because we do some dry food over night when I’m asleep or I also leave it out when I’m out so he has something he can eat in case his blood glucose drops. Thanks for letting me know, I didn’t realize that. It’s all a lot to keep track of 😅. I updated the spreadsheet.

I’m thinking now that I must have given him a fur shot somehow 💔 cause he’s still rising at +3.5 hrs even without eating anything else.
 
rachel & pickle said:
Ah, I see (re needing to be on only wet for TR)—ok, in that case I guess I’ll have to do the SLGS one then because we do some dry food over night when I’m asleep or I also leave it out when I’m out so he has something he can eat in case his blood glucose drops. Thanks for letting me know, I didn’t realize that. It’s all a lot to keep track of 😅. I updated the spreadsheet.

I’m thinking now that I must have given him a fur shot somehow 💔 cause he’s still rising at +3.5 hrs even without eating anything else.
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Rachel, yesterday's AM +11 number is showing up in world number format, rather than US mg/dl numbers. Can you try to remove and then re-enter that number into the sheet to see if it will correct to the US number, please. If it doesn't correct, we'll do the calculation and get it right. It's reading as a bg <68, which I don't think is correct. Also, your spreadsheet says you shot last night; would you please enter that dosage into the spreadsheet.

Thanks!!!
 
Opps sorry about that, should be fixed
Mary & Jude said:
Rachel, yesterday's AM +11 number is showing up in world number format, rather than US mg/dl numbers. Can you try to remove and then re-enter that number into the sheet to see if it will correct to the US number, please. If it doesn't correct, we'll do the calculation and get it right. It's reading as a bg <68, which I don't think is correct. Also, your spreadsheet says you shot last night; would you please enter that dosage into the spreadsheet.

Thanks!!!
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oops! Sorry about that, should be fixed.
 
Hi and welcome! I’m just curious, since you’ve noted EPI with a question mark in your signature. Did the vet run a blood test to confirm before starting Pickle out on pancreatic enzymes? They can be very damaging to the pancreas, unless required so not recommended without positive diagnosis via GI blood panel. Here is some more information EPI - IBDKitties original web page is EPI – IBDKitties
 
Ok he’s superrrrr high now and I’m pretty much certain this has to be a fur shot… can I give his PM shot a bit earlier today? His shot timing got pushed way later than I want it to be anyways.
 
Christie & Maverick said:
Hi and welcome! I’m just curious, since you’ve noted EPI with a question mark in your signature. Did the vet run a blood test to confirm before starting Pickle out on pancreatic enzymes? They can be very damaging to the pancreas, unless required so not recommended without positive diagnosis via GI blood panel. Here is some more information EPI - IBDKitties original web page is EPI – IBDKitties
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Hey! Thanks so much for the warm welcome and for this info. So, from what I’ve been reading/finding, there have been some updates to the research since the author wrote this, but, yeah he was borderline but has multiple conditions that can mask it/lower it (active pancreatitis at the time + chronic kidney disease) and the test is too expensive to do a lot of times (it’s like 500$ where I am). Regardless, at this point, the risk:benefit analysis is strongly in favour of trialing the enzymes over doing nothing. I promise I’m working with an internal medicine specialist who knows Pickle’s complete history and this was their recommendation not just my own dosing.
 
You can adjust his shot time by following the instructions here: Info - Getting back on a 12/12 shot schedule. But the goal should always be to keep Pickle on a 12 hour schedule, and not shoot earlier unless you are adjusting his shot time.

I know those higher numbers can be worrisome, but try not to worry about the higher numbers right now. If you gave a fur-shot or if he is bouncing, he's going to come back down. Try, instead, to focus on the good blues he saw yesterday and today (the nadirs).
 
Mary & Jude said:
You can adjust his shot time by following the instructions here: Info - Getting back on a 12/12 shot schedule. But the goal should always be to keep Pickle on a 12 hour schedule, and not shoot earlier unless you are adjusting his shot time.

I know those higher numbers can be worrisome, but try not to worry about the higher numbers right now. If you gave a fur-shot or if he is bouncing, he's going to come back down. Try, instead, to focus on the good blues he saw yesterday and today (the nadirs).
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Thank you!!! 😅wow it’s so much more reassuring to have other people talk to me about this rather than trying to figure it out alone.
 
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